2021 seasonal influenza vaccines

Influenza vaccines can change from year to year as new strains of influenza virus appear. This is one reason vaccination against influenza is given every year.

The Australian Influenza Vaccine Committee (AIVC) has reviewed data related to epidemiology, antigenic and genetic characteristics of recent influenza isolates circulating in Australia and the Southern Hemisphere, serological responses to 2019-2020 vaccines, and the availability of candidate vaccines viruses and reagents. Based on this review and the World Health Organization's recommendation, the AIVC recommended the viral strains to be used for influenza vaccines in the 2021 southern hemisphere influenza season.

The TGA has accepted the recommendations of AIVC. This year there is a new A (H1N1)-like virus strain and a new A (H3N2)-like virus strain when compared to the composition of quadrivalent vaccines for Australia in 2020.

The egg-based quadrivalent influenza vaccines contain the following four viral strains:

• an A/Victoria/2570/2019 (H1N1)pdm09-like virus;
• an A/Hong Kong/2671/2019 (H3N2)-like virus;
• a B/Washington/02/2019 (B/Victoria lineage)-like virus; and
• a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

The composition of trivalent influenza vaccines is recommended to include the H1N1, H3N2 and the B Victoria lineage virus.

Cell-based quadrivalent influenza vaccines contain the following four viral strains:

• an A/Wisconsin/588/2019 (H1N1)pdm09-like virus;
• an A/Hong Kong/45/2019 (H3N2)-like virus;
• a B/Washington/02/2019 (B/Victoria lineage)-like virus; and
• a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Influenza and COVID-19 vaccination

Can I have the Influenza and COVID vaccine at the same time?

The Australian Technical Advisory Group on Immunisation (ATAGI) has advised that routine scheduling and giving of an influenza vaccine with a COVID-19 vaccine on the same day is not recommended. The preferred minimum interval between a dose of seasonal influenza vaccine and a dose of BNT162b2 (Pfizer) or ChAdOx1-S (AstraZeneca) is 14 days.

If an influenza vaccine has been inadvertently co-administered or given within a shorter interval than 14 days with a COVID-19 vaccine, revaccination with either vaccine is not considered necessary.

Further information for health professionals and consumers regarding influenza and COVID-19 vaccines is available from the Australian Technical Advisory Group on Immunisation (ATAGI) website.

Registered products

For the 2021 influenza season, the following seven influenza vaccines, registered by the TGA, will be available for use in Australia for the age groups listed against each product.

*Guidance for the dose in children aged 6–35 months is available in the product information

All 2021 southern hemisphere seasonal influenza vaccines available for use in Australia are quadrivalent influenza vaccines (QIVs).

Flucelvax Quad, a quadrivalent vaccine produced using mammalian cell culture (for potential use in adults and children 9 years of age and older) will be available in the private market for the first time in Australia for the 2021 season. Another quadrivalent vaccine, Influvac Tetra, will also be available on the private market for children aged 3 years and older.

All other vaccines in the table above will be available free of charge on the National Immunisation Program (NIP). Fluquadri will primarily be available on the private market but will be available for NIP doses as a backup to Vaxigrip tetra doses.

The dose of influenza vaccines for all ages is 0.5 mL.

For further information on individual vaccines, please refer to the relevant Product Information document or Consumer Medicine Information document.

In conjunction state and territory health authorities, the Department of Health will be closely monitoring adverse event reports during the 2021 influenza vaccination program.

Vaccines for use in children

For children, three vaccines are available from 6 months and over: Fluquadri, Fluarix Tetra and Vaxigrip Tetra. Influvac Tetra is available for use in children 3 years and over, Afluria Quad for children 5 years and over, and Flucelvax Quad for children 9 years and over.

All children aged 6 months to less than 5 years are now eligible to receive free annual influenza vaccines under the National Immunisation Program (NIP).

The dose of influenza vaccines for all ages is 0.5 mL.

Vaccines for use in under 65s

Three vaccine brands are being supplied under the NIP in 2021 for people aged under 65 years who are in the following at risk groups: Aboriginal and Torres Strait Islander people, pregnant women, and people who have certain medical conditions: Vaxigrip Tetra, Fluarix Tetra and Afluria Quad. Vaxigrip Tetra and Afluria Quad are registered for all people under the age of 65 years.

Influvac Tetra and Fluquadri are also registered for use in people under the age of 65 years, however both will be available for purchase on the private market only.

Vaccines for use in over 65s

All seven vaccines in the above table of products are registered for use in those aged over 65 years. However, the adjuvanted QIV, Fluad Quad, is preferentially recommended over standard QIVs.

All people aged 65 years and over are eligible for free influenza vaccines under the NIP.

What is in the influenza vaccine?

Information on specific ingredients included within individual influenza vaccines can be found on the label of the medicine, the Product Information (PI) and Consumer Medicine Information (CMI) leaflets for each individual vaccine. You can ask your pharmacist for a copy or find it through our CMI database by searching the product’s name. The CMI provides the full list of ingredients for each product.

Additionally, information on medicines supplied in Australia, including ingredients, can be located by searching the Australian Register of Therapeutic Goods (ARTG) either by product name or ARTG number.

Influenza vaccines available for the 2021 influenza season within Australia do not contain any thiomersal/mercury.

Formaldehyde is used in the early stages of manufacture of some influenza vaccines as an inactivation agent. The formaldehyde is removed in the latter stages of manufacture and the product is tested to ensure formaldehyde levels are below detectable limits before the final product can be released.

All influenza vaccines available this year are latex free. However, the possibility that the product may have come into contact with instruments which contain latex cannot be excluded. Patients who are extremely sensitive to latex should consult their doctor for advice.

Fluad Quad is the only product that contains an adjuvant to boost effectiveness of the vaccine in people aged over 65 years.

Further information

Information for health professionals is available from the ATAGI Influenza Statement. This includes information on the timing of vaccines becoming available for the 2021 season and also the recommended interval between influenza and COVID-19 vaccines

Information for consumers is available from NPS MedicineWise

Additional resources are available on the National Centre for Immunisation Research and Surveillance Website

For more information see Influenza vaccine: the annual Southern Hemisphere influenza vaccine production and the regulatory approval timeline.

Reporting of adverse events following influenza vaccine

Health professionals and consumers are encouraged to report all adverse events associated with influenza vaccination in patients of any age to the TGA or through the current arrangements in their state or territory.

All reports contribute to the TGA's ongoing monitoring of the safety of influenza vaccines.

The TGA cannot give advice about an individual's medical condition. You are strongly encouraged to talk with a health professional if you are concerned about a possible adverse event associated with a vaccine or medicine.